Thrombocytopenia in Infants with Necrotizing Enterocolitis

Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality in preterm infants born before 32 weeks' gestation or with a birth weight less than 1500 g. Thrombocytopenia is a frequently encountered hematologic abnormality in infants with NEC. In many patients, thrombocytopenia can be severe, requiring one or more platelet transfusions. The onset and severity of thrombocytopenia can provide important prognostic information. The pathophysiology of NEC-related thrombocytopenia is unclear, although peripheral platelet consumption seems to be the primary kinetic mechanism. Most patients with NEC show a drop in platelet counts within 24 to 72 hours of onset of abdominal symptoms. NEC-related thrombocytopenia is likely caused by increased platelet destruction, but further study is needed to determine the underlying molecular mechanisms.